Billing consultant vs billing specialist

Differences between billing consultant and billing specialist duties and responsibilities

Billing consultant example responsibilities.

• Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
• Register incoming patients, verify demographics as well as insurance verification.
• Research and determine the viability of collections on all Medicaid accounts receivables.
• Audit EMR system and correct ICD-9 coding errors.
• Review EOB's, and apply payments to the patient's accounts, making applicable adjustments.
• Contact insurance carrier directly, review eob's, reviewing medical records, denials, write appeals.
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Billing specialist example responsibilities.

• Use of QuickBooks to manage vendors' accounts, set up filing system to maintain files and supporting billing documents.
• Manage the daily correspondence with keeping doctor/patient confidentiality under consideration along with HIPPA regulations.
• Use independent judgment, manage and impart confidential information appropriately per HIPAA regulations and company requirements.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Provide additional information/clarification for insurance claims using knowledge of CPT, ICD-9, and HCPCS codes, as well as modifiers.
• Assist staff with proper billing for patients, ensure proper coding using ICD-10, ICD-9 and CPT-4 coding.
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